Overall Ecosystem Health ranked Sinepuxent best followed closely by Chincoteague Bay. St Martin river was ranked worst and Assawoman, Isle of Wight and Newport Bays were all ranked similarly (fair to poor). The ecosystem health index used water quality (water quality index and macroalgae), living resources (benthic index and hard clams) and habitat (seagrass and wetland) indicators that were responsive to human activities and measured throughout the Bays to compare the segments.